Night’s candles are burnt out, and jocund day stands tiptoe on the misty mountain tops.
Spanish life is not always likeable but it is compellingly loveable.
- Christopher Howse: 'A Pilgrim in Spain'
Covid
I had hoped to have ended this section by now but . . .
Some good news: The Covid crisis has vastly accelerated innovation and not just for vaccines. From liquid biopsies to nanotech therapies, these [below] are the other discoveries that will change society for ever.
Europe: Bad news from the WHO.
The EU: Germany might well have abandoned its efforts to have a common (negative) approach - a la Germany’s - towards Brits wanting to enter the EU.
The UK: Despite that, confusion persists about whether fully-vaccinated Brits can avoid quarantine on arrival in, say Spain - especially if one or both of their jabs was manufactured in India.
Spain:
1. The overall incidence rate has jumped another 17 points to 134 per 100,000 inhabitants for the past 14 days and a 3rd region now has an incidence rate above 150 - Andalucia (162), Cantabria (194) and Cataluña (182).
2. For those aged between 12 and 29, the rate now ranges between 345 and 367. Not good.
Cosas de España/Galiza
Mark Stücklin gives us 3 helpful articles today:-
1. Barcelona and Madrid as WFH options
2. How to evict non-paying tenants
3. How to protect your home.
Spain has long been blighted by language ‘wars’, at least in those regions which have a separate official language from Castellano. When I first came to Galicia, every letter you got was in both Castellano and Gallego. Now, there’s rarely any Castellano. And while most web sites will be in both languages, those of the Xunta might well not be. Down in Madrid the pretty-far-right PP president there has just set up an Office of Spanish in the Department of Culture. One wonders why.
In her page cited yesterday, María cites the lack of consideration for others among ‘egocentric’ kids and their parents. I’d go so far as to say this is a major deficiency among the Spanish. True, they can be personable. admirable and even ‘noble’ and they make good Samaritans, if you’re in trouble, but - on a day to day basis - they can show a remarkable lack of consideration for strangers. And they get very upset if told that, by the standards of other cultures, they can be impolite. To put it politely.
Portugal
Good to know . . As of today, the toll on the A3 from Galicia to Oporto is now half of what it was.
The Way of the World/Quote of the Day
Not long ago, in fact around the time of the 2012 Olympics, multicultural Britain was being held up as a beacon of “live and let live” common sense in a turbulent world. Now it's splintering into militant sectarianism. There are people on all sides — anarchic agitators, sinister anti-woke stirrers, outright racists and the merely gullible — who are intent on using culture not to unify but divide. The arts world should rise above this, yet it is being dragged into the mire. . . . Each faction goads the others into more and more ludicrous stances. There’s no meeting of minds any more. Taken from this: It’s time we stopped our cultural life being dictated by mob rule. Click here for more on this.
English
Theses are said to be the 16 words/phrases that will instantly make Brits' teeth itch:-
- Emails at work from complete strangers that start with hoping you are “enjoying the sun” or that you have had a “relaxing weekend”.
-Fascist. Now generally used [o describe a person who has the power to deny you something. In Spain, anyone who disagrees with you]
- Literally. 'There was literally nowhere to park.'
- For sure. An Americanism now used as a faintly patronising alternative to “right” or “exactly”. It implies just a hint of “That’s implicit but it’s not what I’m getting at”.
- Inappropriate. This expresses recognition of wrongdoing without committing yourself to condemning it.
- Three day wedding. What was wrong with a drink and a canapé, speeches, cake, more drink, tears, minicab home?
- Blessed. There are a few words tha make us think of Meghan and 'blessed' is one of them.
- I’m good. As in “I will not be requiring any of your delicious pavlova, thank you so much”. Another Americanism. Fine, but to our ears it always sounds rude.
- TBH. The abbreviation of To Be Honest. A bit like OMG used to be. Slightly ridiculous.
- Cute. This has got more unbearable over time since it can now be applied equally to: a dog; a small child; an elderly man, namely Captain Tom; a bath toy; an owl; a footballer; a table decoration; a sexy text message, a cupcake, a tight T-shirt, and an octopus. It can't be right to use the same word to describe a newborn as an oiled up Love Island contestant in a thong. Cute is now a word meaning awwww and phowar, and maybe the worst.
- Babes. In the same family as cute.
- Barrista. Is it a special skill requiring months of training like, say, a pastry chef, or sommelier? Don’t think so.
- Going forwards. As in “We think this would be a better arrangement, going forwards”. One of those unnecessary add-on creepies. See also, “reaching out”.
- We’re detoxing. It’s possible people don’t say detoxing any more because they’ve switched to “fasting” or “We’re on a no carbs no sugar thing” and that’s a relief because “detoxing” is both irritating and impossible.
- Authentic. As in your goddaughter describing her new boyfriend as authentic, because he refuses to get his haircut in order to secure a job in the hospitality industry.
- Spiritual. Roughly the same.
Yesterday, I thought of a 17th but I can’t now recall what it was. Maybe tomorrow.
Finally . . .
I do, of course, support 2 national footballs teams and the odds are they will meet in the final. In my Pilates class yesterday - admittedly to a degree of scepticism - I insisted its wouldn’t matter to me me which one one. Unless, England outplays Spain but still loses. Worst of all, on penalties.
Note: If you’ve arrived here looking for info on Galicia or Pontevedra, try this.
THE ARTICLE
Five unexpected pandemic breakthroughs. The Covid crisis has vastly accelerated innovation and not just for vaccines. From liquid biopsies to nanotech therapies, these are the other discoveries that will change society for ever
Liquid biopsies
Last spring, as Covid-19 swept across Britain and hospital wards filled with gasping patients, the cancer specialist Dr Angela George came up against a serious problem. “We had patients with what looked like cancers on imaging, but we couldn’t get biopsies,” she says. “There was no capacity.” In normal times cancer treatment can begin only once a biopsy — a small tissue sample from a tumour — confirms the disease is malignant. But with staff diverted to the Covid response and many more sick or isolating, the colonoscopies, bronchoscopies and other procedures needed to take such samples were unavailable. So George, a consultant oncologist at the Royal Marsden Hospital, turned to a technique that has long been held as the future of diagnostics: the liquid biopsy. For years cancer specialists have explored the concept of using these highly sensitive blood tests to detect the DNA shed by tumours to diagnose and monitor cancer precisely without the pain and inconvenience of a biopsy. But despite excitement about the prospects, progress had been slow. Then the pandemic struck and necessity became the mother of invention: experimental techniques were dragged from the future into the present. George’s team started using liquid biopsies to diagnose and treat patients with suspected cancers of the lungs, pancreas, ureter and bile duct. They are now carrying out a clinical trial to try to make the practice routine. While these are early days, eventually doctors hope to be able to do away with surgical biopsies altogether.
Nanotech heroics
If genetic engineering has been the flashy star of the Covid vaccine miracle, lipid nanotechnology has been its unsung hero. Nanotechnology is the vehicle at the heart of the Pfizer and Moderna vaccines, used to transport tiny strands of genetic material called messenger RNA (mRNA) into the body. This prompts cells to start making Sars-CoV-2 proteins, which, in turn, prime the immune system to detect future infection. Scientists have been working on mRNA therapies for decades, but until recently were unable to keep these fragile strands of code intact in the body for long enough for them to transmit their message. Lipids — tiny balls of fat — provided the answer. They encapsulate the RNA, below left, protecting it for long enough to reach the cells.
The potential of the field is enormous. These tiny fat balls — often known as microbubbles — act as a highly effective drug-delivery system. At the University of Oxford’s Institute of Biomedical Engineering, Professor Eleanor Stride is developing a technique where microbubbles, each 100 times smaller than the width of a human hair, are used to deliver chemotherapy directly to cancerous tumours. A beam of ultrasound is targeted at the relevant part of the body. When the bubbles pass through the ultrasound wave, they burst, releasing the medication at the precise point it is needed.
“We can massively reduce the amount of chemotherapy that we need,” Stride says. Rather than flooding the whole blood system with chemotherapy, as is done traditionally, tiny but very concentrated volumes of the drug are used. That means much higher doses can be deployed without the usual side effects
Her team is trialling this approach for brain, pancreatic and bladder cancer, and hopes also to do so for stroke patients by delivering clot-busting drugs directly to the brain.
Bespoke medicine
When we first went into lockdown, the UK had capacity to perform no more than 5,000 Covid tests a day. Since then a vast diagnostics network has been created and up to 1.9 million tests are now carried out daily. Doctors believe this new testing capacity could lead to an era of personalised healthcare. Much of medicine is currently based on educated guesswork. For example, the elderly are given a flu jab because they tend to have weaker immune systems. But instead of assuming there is a drop-off in immunity for all over-50s, why not test for antibodies on an individual basis?
Experts are already investigating the idea of carrying out regular antibody tests to see whether individuals are still protected against coronavirus. If their levels are too low, they would simply have a booster jab.
Straightforward antibody tests could be sent by post to every house in the country. Professor Paul Moss of Birmingham University, who leads the UK Coronavirus Immunology Consortium, says: “I see a way that we will be screened at home, possibly every six months or every year, with a fingerprick test.” The Birmingham team is already using such tests to screen leukaemia patients after they are vaccinated, to measure how their immune systems have reacted to the jab. It could also be used to streamline other immunisation programmes.
Professor Sharon Peacock of Cambridge University, who helped spearhead the Covid genomics effort, believes mass monitoring could be used to track antibiotic resistance — considered to be one of the greatest risks to human health. By routinely decoding the genomes of bacteria, the spread of evolving superbugs could be tracked in the same way that new Covid variants have been mapped.
With schools closed for months on end, the young have had a hard time of it. But one unexpected benefit has been the discovery that age-based school bubbles work wonders for younger children. Segregating pupils into year groups when children returned to school saw year 7 pupils (those aged 11 and 12) flourish, as they were shielded from older pupils and the associated intimidation, bad behaviour and stress, according to research by the Institute for Education in London. The researchers stopped short of recommending complete age-based segregation, but said schools should consider having part of the school dedicated to each year group.
It is an example of the mass human experiment that took place as millions of people were forced into new patterns of behaviour and lifestyle. Lockdown itself, of course, was the biggest experiment of all. When the Chinese city of Wuhan ordered its citizens to stay indoors last January, it seemed inconceivable that the UK could ever follow suit. Yet on March 23, when Boris Johnson told the nation to stay at home to save lives, in our millions we obeyed.
“People are prepared to make very big changes in their behaviour, very quickly, if they see there is a threat and if they see what they can do can make a difference,” says Professor Susan Michie of University College London, who sits on the government’s Sage and behavioural science advisory committees.
Compliance dipped over the summer when government instructions stopped making sense, Michie says. “The mixed messaging, the Eat Out to Help Out policy, the Dominic Cummings fiasco — these dented trust and adherence,” she says. But once infection rates rose again over Christmas we fell back into line. People had understood the risk of the Kent variant and the need to give the new vaccines time to work, Michie says. The lesson? People will change their behaviour to a remarkable extent if they understand the rationale behind it.
Faster clinical trials
In the early days of the pandemic, panicking doctors around the world were trying any drug that had even the slightest chance of tackling Covid. They leapt on antimalarials, antivirals, antibiotics and HIV treatments, despite having no evidence they would work.
So why had doctors abandoned evidence-based medicine? Because in normal times clinical trials take up to a decade. Early on, two Oxford professors, Martin Landray and Peter Horby, designed the Recovery trial, a programme that would dramatically accelerate that process. By inviting every NHS hospital to participate, they could reach a huge trial population. And instead of trialling each drug one by one, they simultaneously tested five treatments. Some 40,000 patients took part.
Last June Recovery showed that dexamethasone, an anti-inflammatory drug that costs just 50p per patient per day, slashed the risk of death among the sickest patients by a third. It has since saved well over a million lives, including 22,000 in the UK. In February an anti-inflammatory called tocilizumab was shown to reduce the risk by another 14 per cent, halving the risk of death to a Covid patient in intensive care.
Earlier this month the trial also showed that a drug developed by the US firm Regeneron cut deaths by 20 per cent among the one in three patients who don’t produce their own antibody response when they contract the virus.
The study also showed that several drugs initially used for Covid — including hydroxychloroquine, which was trumpeted by Donald Trump — gave patients no survival benefit. Recovery has also shown that clinical studies don’t have to take years.
“Trials have become too complex,” Landray says. “It shoots up the costs to something truly ridiculous and the consequence is that people try to avoid doing trials, or they try to make them small and ultra-precise. The problem with a small trial is you might miss the benefit, and the problem with precise trials is you then try to generalise to the real world.”
The concept of bigger, wider, multi-arm trials is already taking hold. A group at UCL has adopted this approach for multiple sclerosis, naming it the Octopus Trial because of its various arms. Landray and Horby were knighted this month in recognition of their work on Recovery.